| NPI | 1053742163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 29691) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 62756) |
| 1223G0001X Dentist, General Practice (Licence: TX 29691) | |
| Enumeration Date | 2013-11-29 |
| Last Update Date | 2022-06-10 |